PREMISE HEALTH OF ILLINOIS MEDICAL PC NPI 1598438434

NPI Information

NPI: 1598438434
Provider Name: PREMISE HEALTH OF ILLINOIS MEDICAL, PC

Doing Business As: ST CLAIRE - BELLEVILLE

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
19 PUBLIC SQ
BELLEVILLE, IL
ZIP 62220
Phone: (843) 918-2040
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PREMISE HEALTH OF ILLINOIS MEDICAL, PC is a multi-specialty clinic center in Belleville, IL. PREMISE HEALTH OF ILLINOIS MEDICAL, PC NPI is 1598438434. The provider is registered as an organization entity type.
The provider Is Doing Business As St Claire - Belleville.

The provider's business location address is:

19 PUBLIC SQ
BELLEVILLE, IL
ZIP 62220-695
Phone: (843) 918-2040

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (615) 468-6270.

The enumeration date for this NPI number is 7/27/2021 and was last updated on 8/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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